Patella tendinopathy

Question 1

What is patella tendinopathy?

Answer 1

Overuse of the patella tendon

Question 2

How to differentiate between patella tendinopathy and patellofemoral pain

Answer 2

Palpation of of tendon is painful in tendinopathy

Question 3

Presentation of patella tendinopathy

Answer 3

Pain with stairs, jumping, squats- loading
Pain localized to inferior patella/patella tendon
Ceases with rest

Question 4

Dominant physiotherapy approach

Recommended frequency

Answer 4

Eccentric loading

3 x 15 twice per day

Question 5

Other options

Answer 5

Stretching

Strengthening surrounding muscles

Question 6

Reducing pain

Answer 6

Avoid activities that compress the tendon
Isometric activities in mid range (where there is no tendon compression)
Could do bilateral activities, fewer reps and shorter holding time if tendon is highly irritable

Question 7

Increasing strength

Answer 7

Exercises with sufficient load in mid range position to avoid tendon compression e.g. leg press mid range hold

Question 8

Strengthening the entire kinetic chain

Answer 8

Strengthen surrounding muscles to take the load off the tendon- quadriceps, glutes, hamstrings

Question 9

Pathophysiology behind eccentric loading

Answer 9

Eccentric loading causes the tendon to lengthen under load and the load stimulates the tendon to undergo structural adaptation.